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History of Ritalin

The symptoms of what we now call Attention Deficit Hyperactivity Disorder (ADHD) were first described by English physician George Frederic Still in 1902. One of the most common drugs used in response to ADHD is Ritalin, which was first marketed in 1957 by the Ciba Pharmaceutical Company. Today, people in the U.S. consume about 90% of all the Ritalin produced.

Some sixty years ago Ritalin was mostly used to treat narcolepsy, a condition characterized by brief involuntary attacks of sleep. A physician noticed certain very active and difficult-to-manage children and tried them on Ritalin and/or amphetamines, a family of drugs with chemical similarities to Ritalin, because of a calming effect seen in some patients who took Ritalin for other reasons. These active children were thought to have a "minimal brain dysfunction," as it was then termed. Medication seemed a better choice for this group of children than the long road of juvenile delinquency that was thought to have awaited them.

When early safety tests were done on mice researchers found that the drug caused an increased in hepatocellular adenomas and, in male mice only, an increase in hepatoblastomas (described as `a relatively rare rodent malignant tumor type'). The significance of these results to humans is unknown' say Novartis, the company selling Ritalin.

Ritalin has been recommended as a treatment for functional behavior problems since the 1960s. When CIBA first suggested this in 1961 they were turned down by the FDA but in 1963 approval was given for this use of the drug.

By 1966 the `experts' had come up with a definition of the sort of child for whom Ritalin could useful be prescribed. Children suffering from Minimal Brain Dysfunction (MBD), the first syndrome for which Ritalin was recommended, were defined as `children of near average, average or above average general intelligence with certain learning or behavioral disabilities ranging from mild to severe, which are associated with deviations of function of the central nervous system. These deviations may manifest themselves by various combinations of impairment in perception, conceptualization, language, memory and control of attention, impulse or motor function'.

Other symptoms which children might exhibit and which could be ascribed to MBD included: being sweet and even tempered, being cooperative and friendly, being gullible and easily led, being a light sleeper, being a heavy sleeper and so on and on. Given that sort of list to work with it is difficult to think of a child who wouldn't benefit from Ritalin - though the official estimate seemed to be that only around 1 in 20 children were real MBD sufferers.

A dramatic increase in the use of medication occurred in the early 1990s. At that time, a group of children who were thought to have ADHD without hyperactivity began to be regularly treated with medication. These children weren?t performing up to expectation in school. They were daydreamers. It was reasoned that they were inwardly, rather than outwardly, hyperactive. The use of Ritalin/amphetamines enhanced their school performance. The floodgates were thrown open. The number of prescriptions for Ritalin/amphetamines in this country continues to skyrocket.

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